鼻腔鼻窦内翻性乳头状瘤恶变鳞状细胞癌中HPV的分布及预后分析  

Distribution of HPV infection and prognostic analysis in patients with squamous cell carcinoma arising from sinonasal inverted papilloma

作　　者：梁青壮 韦伟[1] 陈汶[2] 黄辉[3] 邹霜梅[4] 林青春 乔友林[2] 徐震纲[3] 吴跃煌[3] LIANG Qing-zhuang;WEI Wei;CHEN Wen;HUANG Hui;ZOU Shuang-mei;LIN Qing-chun;QIAO You-lin;XU Zhen-gang;WU Yue-huang(Department of Thyroid Surgery, Peking liniversity Shenzhen Hospital, Shenzhen 518036,China;Department of Epidemiology , Chinese Academy ofMedical Sciences, Peking Union Medical College, Beijing 100021, China;Department of Head and Neck Surgery , Chinese Academy ofMedical Sciences, Peking Union Medical College, Beijing 100021, China;Department of Pathology, Cancer Hospital, Chinese Academy ofMedical Sciences, Peking Union Medical College, Beijing 100021, China)

机构地区：[1]北京大学深圳医院乳甲外科,广东深圳518036 [2]北京协和医学院/中国医学科学院肿瘤医院肿瘤研究所流行病学研究室,北京100021 [3]北京协和医学院/中国医学科学院肿瘤医院肿瘤研究所/头颈外科,北京100021 [4]北京协和医学院/中国医学科学院肿瘤医院肿瘤研究所病理科,北京100021

出　　处：《中国耳鼻咽喉颅底外科杂志》2019年第2期172-176,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：深圳市三名工程项目资助(SZSM201612010)

摘　　要：目的检测人类乳头状瘤病毒(human papillomavirus, HPV)在鼻腔鼻窦内翻性乳头状瘤恶变鳞状细胞癌(squamous cell carcinoma arising from sinonasal inverted papilloma,SCC/IP)中的感染分布,分析两者的预后关系。方法回顾性分析1997年1月~2012年1月符合入组条件的SCC/IP患者共55例,利用"三明治"方法检测其标本HPV的感染状态,采用Kaplan-Meier生存分析法研究患者总生存率和疾病特异性生存率,采用Log-rank检测进行单因素分析,采用Cox模型进行多因素分析,计数资料之间采用卡方检验。结果 HPV感染11例,感染比例为20%(11/55),其中HPV-16型5例,HPV-6型3例,HPV-39型、HPV-18/39型和HPV-33/52/54型各1例。5年总生存率为35.6%,HPV阳性组为18.7%,HPV阴性组为38.9%;5年疾病特异性生存率为42.7%,HPV阳性组为18.7%,HPV阴性组为49.2%。HPV阳性组总体生存率和疾病特异性生存率与HPV阴性组比较,差异无统计学意义(P=0.915,P=0.773), Cox模型分析示HPV状态对总体生存率及疾病特异性生存率亦无影响(P=0.553,P=0.976)。结论 SCC/IP中HPV感染率为20%,HPV感染状态对SCC/IP的预后没有影响。Objective To detect the distribution of human papilloma virus(HPV) infection in patients with squamous cell carcinoma arising from sinonasal inverted papilloma(IP/SCC), and to analyze the relationship between the prognosis and HPV infection.Methods 55 patients with IP/SCC who met the enrollment criteria during the period from Jan.1997 to Dec.2009 were reviewed retrospectively. A "sandwich" technique was used to cut paraffin sections for hematoxylin and eosin(HE) staining and HPV-DNA analysis. Overall survival(OS) and disease specific survival(DSS) for HPV-positive and HPV-negative patients were estimated by Kaplan-Meier analysis. Univariate and multivariate regression analyses were performed using Log-rank and Cox regression model respectively. Counting data were compared via Chi-square test.Results HPV infection was detected in 11 specimens with an infection rate of 20%(11/55). As for the HPV subtype, the case number of HPV-16 infection was 5(45.5%,5/11), HPV-6 was 3(27.3%,3/11),and one(9.1%,1/11) in each of HPV-39,HPV-18/39 and HPV-33/52/54. The 5-year OS rate was 35.6%, while those of HPV-positive and HPV-negative patients were 18.7% and 38.9%. The 5-year DSS rate was 35.6%, while those of HPV-positive and HPV-negative patients were 18.7% and 49.2%. Both differences of OS rate and DSS rate between HPV-positive patients and HPV-negative patients were statistically insignificant(P=0.915, P=0.773). Cox regression model analysis showed that HPV infection had no influence on OS rate and DSS rate(P=0.553,P=0.976).Conclusion With an infection rate of 20% in IP/SCC patients, HPV has no impact on the prognosis of IP/SCC.

关 键 词：内翻性乳头状瘤 鳞状细胞癌 人类乳头状瘤病毒 预后 

分 类 号：R739.62[医药卫生—肿瘤]